The Pharmaceutical Journal
Vol 273 No 7324 p680
6 November 2004

This article
Reprint   Photocopy

PDF 100K, Acrobat Reader

· New contract
· Medicines management
· Registration examination
· Levothyroxine
· Hiccups
· Prescription pricing
· IT
· Personal control
· Control of entry
· Supermarket pharmacies
· Retention fees
· The Society
· The Journal

Letters to the Editor

Levothyroxine

Is levothyroxine suspension effective?

From Mr K. Bird, MRPharmS

My recent experience of the treatment of a hypothyroid baby has given cause for concern regarding the use of extemporaneously prepared suspensions of levothyroxine. ‘Medicines for children 2003’ mentions the use of such a product, which would typically be made from crushed tablets and a suitable suspending agent, eg, Keltrol 0.4 per cent. For a recent patient, such a product was used with no noticeable therapeutic effect. Because of concerns such as whether or not the bottle had been shaken the product was replaced with a fresh supply and support for the parents given via a home-nursing visit.

Unfortunately the substitute also resulted in therapeutic failure; treatment was then altered to a regimen involving levothyroxine tablets and the use of a tablet crusher, which has had the desired effect. These events have been investigated and factors such as preparative technique and patient compliance were examined but the fact remains that this patient did not appear to respond to treatment administered as an oral suspension.

My letter has two purposes: first, to raise concern over the efficacy of extemporaneously prepared suspensions of levothyroxine (this baby did not receive effective treatment for several weeks), and secondly, to see if anyone else has had similar experiences or has comments which they might be prepared to share.

Kenneth Bird
Principal Pharmacist for Medicines Information,
New Cross Hospital,
Wolverhampton
(Tel 01902 695136 or e-mail Kenneth.Bird@rwh-tr.nhs.uk)

Send your letter to The Editor

Previous Topic (Registration examination)
Next Topic (Hiccups)